Learning Curve in Laparoscopic Suturing with Haptic Feedback

Simulators with haptic feedback may not be justified if its benefit is not applicable in surgical skills training. We hypothesized that trainees would reach the first plateau in their learning curve earlier when trained using simulators with haptic feedback, compared with those who trained without haptic feedback. Fifteen novices were randomly assigned to either the haptics group (n=7) or the no-haptics group (n=8). They learned to execute an intracorporeal suture with a square knot over a period of three weeks (1 hour-long session per day, 6 days a week, for 3 consecutive weeks). Learning curves were plotted using task completion time. A trend analysis was conducted based on a predicted mathematical model (S=Smax(1-e^(-slope x Session#)) of maximum speed (Smax) and slope (slope) of the learning curve for each successive session (Session#). Subjective workload assessment for each session was obtained using a standardized NASA TLX workload questionnaire and analyzed using t-test. Results showed that performance variability in each session for subjects in the haptics condition was significantly lower (p